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| Effect of Dexmedetomidine Hydrochloride on hemodynamics and postoperative complications in patients with intracranial aneurysm undergoing interventional surgery |
| SHI Ji1 ZHANG Na′na2 ZHAO Shuai3 LI Weijing4 LIU Ya5 ZHOU Changhao1▲ |
1.Department of Anesthesiology, the First Hospital of Hebei Medical University, Hebei Province, Shijiazhuang 050000, China;
2.Department of Pharmacy, the First Hospital of Hebei Medical University, Hebei Province, Shijiazhuang 050000, China;
3.Department of Clinical Laboratory, the First Hospital of Hebei Medical University, Hebei Province, Shijiazhuang 050000, China;
4.Department of Anesthesiology, the Fourth Hospital of Hebei Medical University, Hebei Province, Shijiazhuang 050035, China;
5.Department of Anesthesiology, the Second Hospital of Hebei Medical University, Hebei Province, Shijiazhuang 050005, China |
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Abstract Objective To investigate the effect of Dexmedetomidine Hydrochloride on hemodynamics and postoperative neurological adverse reactions caused by intracranial pressure (ICP) change during interventional therapy of intracranial aneurysm. Methods From January 2017 to December 2018, 96 cases diagnosed as intracranial aneurysm and receiving elective interventional treatment in the First Hospital of Hebei Medical University were selected as subjects. They were divided into saline group (group A), low-dose Dexmedetomidine Hydrochloride group (group B1), and high-dose Dexmedetomidine Hydrochloride group (group B2) according to the drugs selected and the dose used, with 32 cases in each group. At the time of 30 minutes before ending surgery , Dexmedetomidine Hydrochloride was injected into B1 and B2 groups at 0.6 μg/kg and 1.2 μg/kg and continued for about 20 minutes, while group A was pumped in saline. ICP, mean arterial pressure (MAP) and heart rate (HR) of the three groups were recorded at the time of the preoperative (T0), administration (T1), ending surgery (T2), recovery (T3), extubation (T4) and post-extubation (T5). Postoperative recovery indicators (recovery time, postoperative extubation time and Ramsay sedation score) and incidence of neurological adverse reactions of three groups were compared. Results ICP of group B1 was lower than that of group A at T2-T4, MAP and HR of group B1 were lower than those of group A at T2-T5, and the differences were statistically significant (all P < 0.05). At T2-T4, ICP of group B2 were lower than those of group A and B1, MAP of group B2 were lower than those of group A and B1 at T2-T5, HR of group B2 was lower than that of group A and B1 at T1-T5, and the differences were statistically significant (all P < 0.05). Compared with group A, group B1 showed no statistically significant difference in the recovery time and postoperative extubation time (P > 0.05). Ramsay sedation score in group B1 was higher than that in group A, with statistically significant difference (P < 0.05). The recovery time and postoperative extubation time of group B2 were longer than those of group A and group B1, Ramsay sedation score of group B2 was higher than that of group A and group B1, and the differences were statistically significant (P < 0.05). The incidence of postoperative adverse reactions in the nervous system of three groups were significantly differences (P < 0.05). The incidence of adverse nervous system reactions in group B1 and B2 were significantly lower than those in group A, with statistically significant differences (all P < 0.05). There was no significant difference in the incidence of neurological adverse reactions between group B1 and group B2 (P > 0.05). Conclusion Small doses of Dexmedetomidine Hydrochloride before ending surgery can effectively stabilize the hemodynamics of patients, improve cerebral perfusion, reduce intracranial pressure and the incidence of postoperative neurological adverse reactions. Early intervention with Dexmedetomidine Hydrochloride produces beneficial application value in patients with intracranial aneurysm undergoing interventional surgery.
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